Non-Pharmacologic Interventions for Older Adults with Subjective Cognitive Decline: Systematic Review, Meta-Analysis, and Preliminary Recommendations
In subjective cognitive decline (SCD), older adults present with concerns about self-perceived cognitive decline but are found to have clinically normal function. However, a significant proportion of those adults are subsequently found to develop mild cognitive impairment, Alzheimer’s dementia or other neurocognitive disorder. In other cases, SCD may be associated with mood, personality, and physical health concerns. Regardless of etiology, adults with SCD may benefit from interventions that could enhance current function or slow incipient cognitive decline. The objective of this systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, is to examine the benefits of non-pharmacologic intervention (NPI) in persons with SCD. Inclusion criteria were studies of adults aged 55 + with SCD defined using published criteria, receiving NPI or any control condition, with cognitive, behavioural, or psychological outcomes in controlled trails. Published empirical studies were obtained through a standardized search of CINAHL Complete, Cochrane Central Register of Controlled Trials, MEDLINE with Full Text, PsycINFO, and PsycARTICLES, supplemented by a manual retrieval of relevant articles. Study quality and bias was determined using PEDro. Nine studies were included in the review and meta-analysis. A wide range of study quality was observed. Overall, a small effect size was found on cognitive outcomes, greater for cognitive versus other intervention types. The available evidence suggests that NPI may benefit current cognitive function in persons with SCD. Recommendations are provided to improve future trials of NPI in SCD.
KeywordsMild cognitive impairment Alzheimer’s disease Complementary therapies Cognitive interventions Treatment outcome
CMS was supported by the Alzheimer Society of Canada (Young Investigator Award #1216). CH was supported by a Salary Award (Chercheur-boursier, Senior) from the Fonds de Recherche du Québec–Santé. AT was supported by BRACE-Alzheimer’s Research (Registered Charity 297965). HH is supported by the AXA Research Fund, the Fondation Université Pierre et Marie Curie and the “Fondation pour la Recherche sur Alzheimer”, Paris, France. The research leading to these results has received funding from the program“Investissements d’avenir” ANR-10-IAIHU-06. The authors are grateful to Dr. Simone Lista for research assistance with completion of this study.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
The referenced article Smart et al. (2016) was performed by the first author, and all procedures performed were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Beyond this referenced article, the current article does not contain any studies with human participants performed by any of the authors.
In the referenced article Smart et al. (2016), conducted by the first author, informed consent was obtained from all individual participants included in the study.
Note: citations marked with an asterisk (*) were those included in the meta-analysis
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